Nursing Elites

1. The nurse is planning discharge teaching for four mothers. Which postpartum client is at highest risk for psychological difficulties during the postpartum period?

• A. A primiparous woman who has recently migrated to the US with her spouse
• B. A multiparous client who lives with her husband and his family members
• C. A multiparous female with a large family living in a community
• D. A primiparous adolescent living at home with her parents and significant other

Correct answer: A

Rationale: A primiparous woman who has recently migrated to the US with her spouse is at the highest risk for psychological difficulties during the postpartum period. Recent migration and adjustment to a new environment can increase the risk of postpartum depression, especially when combined with the challenges of being a new mother. Choice B, a multiparous client living with her husband and his family, may have social support from family members, which can be protective against psychological difficulties. Choice C, a multiparous female with a large family living in a community, also indicates potential social support. Choice D, a primiparous adolescent living at home with her parents and significant other, may have a support system in place with her family and significant other.

2. A client who is at 24 weeks of gestation is receiving teaching about expected changes during pregnancy. Which of the following information should the nurse include?

• A. Your stomach will empty rapidly
• B. You should expect your uterus to double in size
• C. You should anticipate nasal stuffiness
• D. Your nipples will become lighter in color

Correct answer: C

Rationale: Nasal stuffiness is a common symptom during pregnancy due to increased blood flow and hormonal changes. This symptom is caused by the increased blood volume and hormonal changes that lead to swelling of the nasal passages. Choices A, B, and D are incorrect. Stomach emptying rate does not significantly change during pregnancy; the uterus does not double in size at 24 weeks but rather grows steadily, and nipples typically darken in color due to increased pigmentation.

3. Rico is a man who has enlarged breasts and suffers from mild mental retardation. He has a problem learning languages, and his body produces less of the male sex hormone testosterone than normal males. Rico is most likely suffering from:

• A. Klinefelter syndrome.
• B. Tay-Sachs disease.
• C. Turner syndrome.
• D. Down syndrome.

Correct answer: A

Rationale: Rico's symptoms align with Klinefelter syndrome, which is characterized by an extra X chromosome in males (XXY). Enlarged breasts (gynecomastia), mild mental retardation, learning difficulties, and reduced testosterone production are common features of Klinefelter syndrome. Choice B, Tay-Sachs disease, is a genetic disorder that affects the nervous system and is not associated with the symptoms described. Choice C, Turner syndrome, occurs in females with a missing or partially missing X chromosome and does not fit Rico's profile. Choice D, Down syndrome, is caused by an extra copy of chromosome 21 and typically does not present with the symptoms mentioned for Rico.

4. On the first postpartum day, the nurse examines the breasts of a new mother. Which condition is the nurse most likely to find?

• A. Firm, larger, and very tender to the touch
• B. Slightly firm with an immediate let-down response
• C. Soft with no change from before delivery
• D. Filling and secreting colostrum

Correct answer: D

Rationale: On the first postpartum day, the nurse is most likely to find the breasts filling and secreting colostrum. Colostrum secretion is common as the body prepares for breastfeeding in the initial days after delivery. Choice A is incorrect as breasts are not typically very tender immediately postpartum. Choice B is incorrect as an immediate let-down response is more related to lactation rather than the first postpartum day. Choice C is incorrect as the breasts typically undergo changes, such as filling with colostrum, after delivery.

5. Are babies with fetal alcohol syndrome (FAS) often larger than normal, and so are their brains?

• A. TRUE
• B. FALSE
• C. Sometimes
• D. Always

Correct answer: B

Rationale: The correct answer is B: FALSE. Babies with fetal alcohol syndrome (FAS) are typically smaller than normal, with smaller brains and developmental issues. Choice A is incorrect because babies with FAS are not larger than normal. Choice C is incorrect as it does not accurately reflect the typical characteristics of babies with FAS. Choice D is incorrect as babies with FAS are not always larger than normal.

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